Manifestations of tuberculosis in breast

ABSTRACT

The aim of this study was to highlight the importance of tuberculosis as a cause of breast diseases. Retrospective study from 2000 to 2005. This study was conducted at Sarfaraz Rafiquee Shaheed Hospital and Civil Hospital, Karachi. All patients who were diagnosed as cases of tuberculous mastitis were included in the study. In all patients the biodata and a detailed history was taken and a thorough examination performed. Relevant investigations that were done included CP and ESR, X-ray Chest, Mammography, Mantoux Test, Sputum for acid fast bacilli, Discharge from sinuses for detection of acid fast bacilli and culture, Biopsy and histopathological examination. All patients underwent surgery with removal of the infected breast tissues, combined with anti-tuberculous chemotherapy. A total of seven cases were detected during the study period with tuberculosis of the breast. All were females with an age range from 17 to 50 years, but the majority were under 30 years of age. The duration a/their symptoms ranged from six months to two years. The main symptoms and signs were multiple discharging sinuses over the breast [n=3], painless lump [n=2], painful lump [n=1], ulcer [n=1], ipsilateral axillary lymphadenitis [n=3] and pulmonary tuberculosis [n=2]. The diagnosis was made on histopathology in all the cases; six cases belonged to the nodular tuberculous group, while one had disseminated tuberculous mastitis. Acid fast bacilli were detected in only two specimen, while positive culture was obtained in only one patient. Successful outcome was seen following treatment comprising of anti-tuberculosis drug therapy with removal of the infected breast tissue in six and mastectomy in one patient. This study establishes the importance of including and remembering tuberculosis in the list of the causes of breast diseases, specially in cases of recurrent abscesses, sinuses and lumps